Tuesday, November 04, 2008

In the States medical cannabis is a massive issue (far more politically potent than its marginal status in the UK), being entwined with a raft of other political and cultural battles; the bigger recreational cannabis issue, tensions between federal and state power, various medical prescribing politics and more besides. It can all get quite rather confused and often real issues about the future of drug policy seem to get lost in the mix as emotions run high on both sides of the various debates. Personally I have mixed feelings about the issue, in particular a concern that conflating the medical and recreational debates potentially threatens to undermine progress on both. That said, I certainly don't want to see medical users criminalised*.

None of this, however, should get in the way straight reporting of facts and the Office of National Drug Control Policy (ONDCP) , the most ferocious opponent of medical cannabis, or 'medical cannabis' as they like to mockingly call it, has made some bold and seemingly inaccurate claims about San Francisco dispensaries in its latest blog post. I say 'blog' despite it not really warranting the moniker, being one of those prohibitionist 'blogs' that does not publish comments, presumably afraid of the roasting they would get if they opened themselves up to that strange concept of democratic engagement and free debate (to my knowledge there are no official prohibitionist blogs that publish comments, and many, like Costas Corner, don't even let you make them) .

One of 'less than 30' cannabis dispensaries in Down town San Franscisco

Various SF based medical cannabis practitioners and activists have been quick to point out the claims appear to be incorrect:

This response was posted on the ONDCP 'blog' by a representative of NORML (not that you will be able to read it because ...democracy...etc.) ;

This is total bunkum. The number of cannabis clubs in SF is limited by city ordinance and has never exceeded 40. A listing of currently active clubs may be found at our website http://www.canorml.org/prop/cbclist.html#sf. It shows 22 clubs and 5 delivery services. There is also one other unlisted club registered with the city. By contrast, there are 3,500 licensed liquor outlets in SF.

The information contained in the Czar's blog is not even close to resembling truth...in fact SF Gate (the e-version of the Chronicle) noted in a recent article (Aug 27) about the AG guidelines that SF only has about 26 MCDs currently in operation. Even at the height of 'unregulated' access in SF, there was no where near that many MCDs!

The local ASA chapter is tracking MCD permits in SF with painstaking attention to detail. At present, 28 collectives have submitted applications for permits. A few have been denied and there are 4 collectives that have permits to operate under local law. There are another 20 or so collectives in operation, and these collectives have until Jan 19, 2009 to acquire their permits (part of the grandfather provision we included in the legislation). Obviously not all collectives will survive the permit process, and a few of these collectives are in the process of sorting out some legal battles. But, with absolute confidence, I can tell you that there is no where near 100 collectives operating in SF.

And, finally, not to beat a dead horse, but some of the locations of the info provided on the Drug Czars so-called "map" includes places where dispensaries are absolutely prohibited by local land-use law from operating. The map below, is the current map that details "green-zones" or those places where MCDs may be permitted by the SF government to operate once they have obtained a permit http://www.sfgov.org/site/uploadedfiles/planning/Applications/MCD_Map.pdf

and a local medical cannabis group that:

As far as we know, there are now a little fewer than 30 dispensaries or so, so this is more misinformation from the drug czar.

I'm happy to be corrected on this (comments welcome here - all published un-moderated), but if, as the above information would suggests the ONDCP's claim is substantially non-congruent with reality (less than a third does not constitute 'more than') and has been playing silly statistical propaganda games again, let's hope they are similarly willing to publish a correction.

Medical cannabis as an idea was always devalued by the NORML statement (Stroup I think it was ) that medical pot would be used as a Trojan Horse for legalisation. To its credit, Transform has steered clear of that sham.*************Marijuana

Don't buy the "medical marijuana" lie! How many other approved medicinesare:* Smoked? 0. * Come in unmeasured doses? 0. * Have unknown strengths? 0. * Taken as often as you think needed? 0. * Taken in crude form(aspirin from tree bark)0 * Are voted on by the public? 0.* Circumvent safety of FDA testing? 0. * Contain no warnings on harm? 0. * Are recommended by doctors, not prescribed? 0. * Allow a person to grow or produce their own medicine? 0. * Allow some unnamed doper dude to hold your stash? 0. One exception to any of the above would be amazing, but all of them? Don'tbuy the lie!

Marijuana is the most widely used substance impacted by prohibition. Many people, right or wrong, would care less about other reforms if pot prohibition was repealed.

Changes to pot laws ( which have to be made by voters for complex political reasons ) to allow its use because of its proven medical therapeutic value might help prohibition reforms in general. When it is allowed for such, and "the sky doesn't fall", it lends credence to the theory that drugs in general can be controlled and regulated. I think the significance is much greater than marginal.

As for david raynes comments, unless he is speaking semantically about the term medicine, he is so far from reality that I don't see why reforms are of even of consequence to him anyway.

His short "proofs" are lacking.

Here's one of mine - "If you stand outside and watch the sky, doesn't the sun move from east to west? Therefore, if the earth is round, the sun must be going around the earth. Sounds good, but it's more complex than that just as his short proofs are.

Only someone ignorant of what science has found out about marijuana or someone biased against it for some reason thinks as he does.

If one smokes opium, it will help insomnia and relieve pain regardless of the "strenght" and "measured dosing".

It would take too much space to refute his other simplistic arguments, but since he mentioned NORML, I'll add a link to their information on pots medical value and the PDF from the 2008 International Cannabinoid Research Societies symposium. Note all the Pharmaceutical companies interested in cannabinoid ( marijuana ) medicines. Also note the dozens ( but there are about 17,000 out there ) of different research papers on things various compounds in marijuana can do. It is the most valuable medicinal plant since the opium poppy in terms of broad spectrum value.

Regardless of whether it's smoked or not.

My apologies for my being impolite, but such thinking about pot ( having no medical value ) has caused, and is causing, tens of thousands, or more, to suffer. The DEA even buried a report back in 1974 about its potential anti-cancer value.

David - i agree with your initial point about the piggy backing of medical and recreational cannabis reform debates has not been useful (and has the potential to undermine both - I really think they need to be engaged independently). Whilst I'm sure that some people adopt the trojan horse position there are certainly many sincere campaigners who are only interested in medical access.

I also agree that smoked cannabis is not an appropriate prescribed medicine - and should not be exempt from the standardised licensing procedures. That said there are plenty of rational ways forward (e.g. sativex), and i cant help feeling that most of the objections - just like the even less arguable ones for industrial hemp - are also tied up in the culture war/recreational issues. That is just a much of a shame as the trojan horse silliness IMHO.

What about the cost of Marinol, which is only THC? Causes some to hallucinate and isn't effective against afflictions targeted by the other cannabinoids.

So, it's better for us to take the High Road and let someone in the throes of chemo induced nausea without an appetite pay out the nose for Marinol or Sativex, even if they don't work as well as a few tokes of pot, rather than allow "medical cannabis" because it's really "just a lie".

I hope those who so vociferously oppose medicinal pot simply because it's not an (politically and monetarily skewed) approved dose in a pill or spray never get cancer, and that if they do they're well-insured or rich enough to afford specific pharmaceuticals. They just might change their position when they are the ones suffering.

Anyone who has ever routinely smoked pot knows that dosing is very easy. Sure, you have a new dose with a new batch, maybe a toke or two less or more, but that's a very small issue. Sometimes one tylenol doesn't help a headache and you have to take more.

I must be missing something. Steve did say "appropriate prescribed medicine". This is so easy to understand with a few facts, and this is a Transform - reform oriented? - website.

jim - i've never disputed the efficacy of cannabis for certain conditions. Ive witnessed it myself when a friend of mine had secondary tumors throughout his body and was on chemo for nearly a year - his doctors not only allowed him to smoke cannabis on the oncology ward's roof terrace, they rolled the joints for him when he was no longer able to do it himself because he had no sensation in his hands. It was remarkably effective as relief for some of the worst symptoms of the treatments he was on. He was also given marinol but found it ineffective, slow acting, and impossible to dose effectively. I wouldn't want to deny anyone the relief he had - nor would the doctors and nurses on my firends ward - and would be outraged if they were criminalised for it.

That said I dont accept that smoking is ever going to be a medically acceptable method of consuming any medication in the longer term for good reasons. I'm aware that vaporisers offer the same level of dosing control without the risks associated with combustion of the plant material.

I also understand the objections to licensing a herbal products - even if the product itself can be standardised. Why should one herbal medicine not be subject to the same controls and licensing as all other mediciens - plant based or otherwise - are subject to?

Tolerating its use under certain licensed conditions seems like a sensible pragmatic compromise to either criminalisation or total deregulation, in the short to medium term - effectively what happens as I understand it.

I assume if it is licensed for recreational use then the medical issues would be largely irrelevant - as presumably they are in Holland - people can self medicate as they chose regardless.

In the longer term - I look forward to the continuing research into the active ingredients in the plant, either used separately or in combination, and finding safe and effective ways of administering them.

"Why should one herbal medicine not be subject to the same controls and licensing as all other mediciens"

Why should herbal medicines that have been used for thousands of years be controlled at all? As if we should need governments permission to self medicate with anything! They should issue guidelines, not nanny state statutes.

Some 'Herbal' medicines are safer with fewer side effects that their 'pharmaceutical' copies, Aspirin kills thousands, willow bark tincture does not, fact.

Herbal cannabis will always be more beneficial than single compound "pharmaceutical" cannabis compounds, natural cannabis has about 60 times the potential of ant single compound.

Has it not crossed any ones mind that recreational users are self medicating for stress relief? I know I do :)

Pro-prohibition Blogs that don't allow comments should be called a "Plog" Propaganda Log ;)

Bubble - I understand where you are coming from but the fact is we have a regulatory system for medicines - albeit - and imperfect one - for good reason. I don't think that because a medicine is herbal it is exempt from that system and also dont buy the 'authority of the ages' argument. Its cultural heritage doesn't give it special status in the modern world.

There are ofcourse plenty of herbal medicines that dont work or that are actively dangerous. Like every other psychoactive compound cannabis is not without risks - and this is my my personal opinion BTW - it should be regulated accordingly. It might be that it was deemed sufficiently low risk to be sold like asprin - another plant derived drug. But even asprin has had to go through the rigors of the licensing process and is subject to strict product and packaging controls.

It may also be that the reality of the ease with which cannabis can be procured/grown means that the regulatory system needs to be somewhat different from most drugs. that does not mean however that people who sell or supply it for medical purposes should be exempt from controls.

Thanks Steve, I see your point, but the regulatory mechanism is already corrupt (codex). When it is played out to it's natural end, there will be no "natural" medicine allowed, only pharmaceutical grade compounds that have gone through expensive "trials" even though most are not as effective as the original "natural" un-patentable compound.

"Dr Verkerk,(google for more) from the Alliance for Natural Health, says:

'Our ability to choose natural health is at risk. For the last half century, a mechanism (Codex Alimentarius) has been in place to hand over control of our key commodities, namely energy, food and health products, to transnational corporations, working in cahoots with governments. Now it is about to be activated. We may be getting used to the fuel and food price increases - but are we ready to say goodbye to our freedom to choose natural health?'

Those expensive "trials" will never compare the natural compound to the synthetic, just the effectiveness of the synthetic, which can be statistically manipulated.

Going back to Aspirin, it kills 300 - 500 people per year in the UK, (40k worldwide) and that's if taken in line with the recommended dose! Sold over the counter with zero real life retail controls!

I suppose I don't need to remind anyone Cannabis doesn't kill!

The original safe compound from Salix bark was salicin, Karl Löwig (1839) treated salicin with acid, creating the forerunner to aspirin, but it caused stomach upset. A different compound was synthesized in 1853 by Carl von Gerhardt by putting an acetyl group on salicylic acid, making acetylsalicylic acid, which is a chemical salt (solid). This was the new "drug" aspirin, which kills.

I view the regulatory procedure as a monopoly protection for pharmaceutical compounds. Each compound, vitamin, or medicine is supposed to be assessed on it's merrits, but like all other EU shenanigans, everything is rubber stamped into stone [as per the pharmaceutical industries direction] with zero oversight.

I know where you're coming from but I don't think the concept 'naturalness' has any meaning or intrinsic merit in and of itself - and is only loosely defined. Medicines need to be properly regulated and tested to protect consumers from exploitation and minimise risk. I have no love for most big pharmaceutical companies (although the achievements of medical science are obvious) but if we don't like the way regulation is happening at the moment the system needs reforming, not abandoning.

While I am hesitant to risk giving credence to David Raynes nonesense by correcting him on this but I have a salbutamol inhaler here prescribed by my doctor that specifically states to take 1-2 Puffs AS NEEDED as the doctors instructions on the pharmacy label.

In fact such instructions are used with other medicines including GTN (For Angina) are also used as needed, such dosing regimes even have a specific medical abbreviation for it, the abbreviation for administer as needed is PRN (from the Latin pro re nata).

However your post David is nonesense anyway I just thought I would correct that glaring error.

Yes, I also had a post-op (appendectomy) diamorphine(heroin) that was administered intravenously by me as needed, using a button velcroed to my hand. Some of David's list, fair enough, but a lot of it is just silly. you don't need to smoke it, it can be of known strength, it can have health warnings and come from a licensed supplier and so on. Even the criticisms that remain disapear with products like sativex.

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